European Association for Vision and Eye Research

The study objective was to explore the microscopic structure of soft macular drusen and surrounding retinal areas using an adaptive optics (AO) camera and to compare the findings to those from standard clinical examinations.

18 patients of age between 65 and 85 and presenting soft macular drusen were recruited after aninitial scanning laser ophthalmoscope (SLO) examination. We used an AO flood-illumination system to acquire high-resolution images of selected drusen areas. Every acquisition provided a series of 20 consecutive reflectance images, out of which 10 were numerically averaged to produce an enhanced final image. The resulting AO images were analyzed in comparison with conventional infrared and autofluorescence fundus images and spectral optical coherence tomography scans.

The soft drusen were visible in AO images as generally round areas delimited by a peripheral low-reflectance line. Hyper reflective spots of size comprised between 2 and 15 μm were observed in many drusen inner areas. These bright spots were sometimes isolated, sometimes grouped into tight aggregates of 2 to 40 components. Cone photoreceptors were visible in areas between drusen in most AO images.

The microscopic structures observed in the AO images of soft drusen presents analogies with their described anatomopathologic characteristics, which could not be identified using other in vivo imaging techniques. AO technology could help to refine the clinical classification of macular drusen and obtain deeper insight in their link with the development of different types of advanced AMD.

Author Disclosure Information: N. Massamba, None; B. Lamory, Imagine Eyes, G. Soubrane, None.